Hi,
Been taking 2.5 grains of Thiroyd NDT for the last year (1 @ 07.30, 1 @ 15:00, 0.5 @ 23:30). I was on 150mcg of Levo prior to this for 10+ years.
Just got my latest test results (done annually).
The blood was taken at 08:00 prior to any NDT being taken.
TSH is high @ 4.6. T4T is on borderline low. FT4 is low.
Do you think it is worth increasing the night dose to a whole grain now, taking the total to 3 and see if I get hyper symptoms?
TIA, Paul
Just to add that my FT3 is pretty good. So maybe dosing with say 25mcg of Levo for the T4 boost would be better than increasing the NDT?
If I were you, I'd increase by 1/4 grain, not a half grain. Your FT3 is only just over mid-range, so could be higher. And your TSH is still high. 1/4 grain might do it. 
Of course, you do have Hashi's. So, you do need your TSH lower. Are you gluten-free?
Thanks for the reply.
Re gluten pretty much... I only very occasionally eat bread, pasta, wheat etc. I've also drastically reduced starchy carbs intake for the last 6 months, which has totally eliminated my bloating and I feel so much better in myself. I've also lost 2 stone as well! I do still eat sufficient carbs daily, so as to not potentially impair the remaining thyroid function I have left as I appreciate the role that carbs play in the T4/T3 conversion process.
Gluten-free is 100% or nothing. Occasionally eating gluten will completely scupper any benefit you were having from the gluten-free diet. But, if you don't feel bad after eating gluten, perhaps you don't need to be gluten-free anyway.
I appreciate that, it's just sometimes I slip up - party food mainly or when the kids leave some pizza! ;-). I normally then find that within a few hours of eating it, and for the next couple of days, I get bloated again.
Whether it's gluten or something else, the bloating that I've suffered from for at least the last 10 years was something that went away very quickly after I made the changes to the carbohydrate element of my diet. Also i can now drink milk again without issue too, which for the last 10 years or so has given me intestinal cramps.
Have you tested your vitamin D recently?
Do you supplement vitamin D, if so how much
As greygoose says if your not 100% absolutely strictly gluten free it doesn't work.
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
thyroidpharmacist.com/artic...
I've not actually had vitamin D tested, but I do supplement - I think it is 5mcg daily.
I also eat cheese and eggs almost daily, and fatty fish twice a week so there's the dietary intake too.
With thyroid disease, gut is often badly affected and malabsorption
We are not what we eat, but what we absorb
Suggest you get tested
Vitamindtest.org.uk £29 NHS postal kit
It's really not a good idea to supplement vit D without testing first. Excess vit D is toxic. That said, you're not going to go very far with 5 mcg. But, do try and get it tested.
However, the reason we need to supplement is that hypos tend to have low stomach acid, and therefore difficulty digesting and absorbing nutrients. We can have the most perfect diet in the world, but if we have low stomach acid, we're going to have low nutrients. And we should test to find out how much we need to take.
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